Citation

Jones TJ, Bhattacharya B, Schuster KM, Becher RD, Kodadek LM, Davis KA, Maung AA. Trauma Surg. Acute Care Open 2023; 8(1): e001047.

Copyright

(Copyright © 2023, The author(s) and the American Association for the Surgery of Trauma, Publisher BMJ Publishing Group)

DOI

10.1136/tsaco-2022-001047

PMID

37188153

PMCID

PMC10175962

Abstract

OBJECTIVE: To identify the rates and possible predictors of alcohol withdrawal syndrome (AWS) among adult trauma patients.

METHODS: This is a retrospective review of all adult patients (18 years or older) included in the 2017 and 2018 American College of Surgeons Trauma Quality Program Participant User File (PUF). The main outcomes were rates and predictors of AWS.

RESULTS: 1 677 351 adult patients were included in the analysis. AWS was reported in 11 056 (0.7%). The rate increased to 0.9% in patients admitted for more than 2 days and 1.1% in those admitted for more than 3 days. Patients with AWS were more likely to be male (82.7% vs. 60.7%, p<0.001), have a history of alcohol use disorder (AUD) (70.3% vs. 5.6%, p<0.001) and have a positive blood alcohol concentration (BAC) on admission (68.2% vs. 28.6%, p<0.001). In a multivariable logistic regression, history of AUD (OR 12.9, 95% CI 12.1 to 13.7), cirrhosis (OR 2.1, 95% CI 1.9 to 2.3), positive toxicology screen for barbiturates (OR 2.1, 95% CI 1.6 to 2.7), tricyclic antidepressants (OR 2.2, 95% CI 1.5 to 3.1) or alcohol (OR 2.5, 95% CI 2.4 to 2.7), and Abbreviated Injury Scale head score of ≥3 (OR 1.7, 95% CI 1.6 to 1.8) were the strongest predictors for AWS. Conversely, only 2.7% of patients with a positive BAC on admission, 7.6% with a history of AUD and 4.9% with cirrhosis developed AWS.

CONCLUSION: AWS after trauma was an uncommon occurrence in the patients in the PUF, even in higher-risk patient populations. LEVEL OF EVIDENCE: IV: retrospective study with more than one negative criterion.

Language: en

Keywords

Multiple Trauma; risk factor; alcoholism